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Individual

DR. KEVIN TODD PAVELONIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
B.A.D.C.

Contact information

Practice address
4640 DIXIE HWY, LOUISVILLE, KY 40216-2606
(502) 447-3333
(502) 447-3387
Mailing address
4640 DIXIE HWY, LOUISVILLE, KY 40216-2606
(502) 447-3333
(502) 447-3387

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3870
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1122687
PASSPORT
KY
01
2437190000
PASSPORT ADVANTAGE
KY
05
85036481
KY
Enumeration date
01/09/2007
Last updated
12/19/2017
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